Insulin resistance in children: Consensus, perspective, and future directions

Claire Levy-Marchal, Silva Arslanian, Wayne Cutfield, Alan Sinaiko, Celine Druet, M. Loredana Marcovecchio, Francesco Chiarelli*, Shin Amemiyia, Gerald Berenson, Sonia Caprio, Marie Aline Charles, Stephen Cook, Elizabeth Davis, Larry Dolan, David Dunger, Anne Fagot-Campagna, Carl Erik Flodmark, Earl Ford, Jean François Gautier, Elizabeth GoodmanMichael Goran, Morey Haymond, Paul Hofman, Anita Hokken-Koelega, Lourdes Ibanez, So Jung Lee, Claudio Maffeis, Veronica Mericq, Boyd Metzger, Svante Norgren, Ken Ong, David Pettitt, Mary Rudolf, Jeffrey Schwimmer, Julia Steinberger, Ram Weiss, Chittaranjan Yajnik

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

267 Scopus citations

Abstract

Objective: Emerging data indicate that insulin resistance is common among children and adolescents and is related to cardiometabolic risk, therefore requiring consideration early in life. However, there is still confusion on how to define insulin resistance, how to measure it, what its risk factors are, and whether there are effective strategies to prevent and treat it. A consensus conference was organized in order to clarify these points. Participants: The consensus was internationally supported by all the major scientific societies in pediatric endocrinology and 37 participants. Evidence: An independent and systematic search of the literature was conducted to identify key articles relating to insulin resistance in children. Consensus Process: The conference was divided into five themes and working groups: background and definition; methods of measurement and screening; risk factors and consequences; prevention; and treatment. Each group selected key issues, searched the literature, and developed a draft document. During a 3-d meeting, these papers were debated and finalized by each group before presenting them to the full forum for further discussion and agreement. Conclusions: Given the current childhood obesity epidemic, insulin resistance in children is an important issue confronting health care professionals. There are no clear criteria to define insulin resistance in children, and surrogate markers such as fasting insulin are poor measures of insulin sensitivity. Based on current screening criteria and methodology, there is no justification for screening children for insulin resistance. Lifestyle interventions including diet and exercise can improve insulin sensitivity, whereas drugs should be implemented only in selected cases.

Original languageEnglish (US)
Pages (from-to)5189-5198
Number of pages10
JournalJournal of Clinical Endocrinology and Metabolism
Volume95
Issue number12
DOIs
StatePublished - Dec 2010

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Endocrinology
  • Clinical Biochemistry
  • Biochemistry, medical

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